# Disparities in Distress Symptoms Among Cancer Inpatients, Outpatients and Relatives Through Introducing and Evaluating Digital Distress Screening

## TL;DR

This study shows that digital screening tools can effectively assess distress in cancer patients and their relatives, with high acceptance when users have hands-on experience.

## Contribution

The study introduces and evaluates digital distress screening tools, highlighting their usability and acceptance across different cancer care groups.

## Key findings

- Digital screening with text-based instructions was more effective than analogue or video-based methods.
- Participants reported high satisfaction with digital screening, especially with hands-on experience.
- Inpatients without a wish for counseling had different distress profiles compared to those who wanted counseling.

## Abstract

Cancer treatments and survival rates have significantly improved, yet distress in patients and their relatives remains overlooked, leaving them with needs unmet. One contributing factor is inadequate screening, which could be improved by digitalisation. This study examined differences in distress among outpatients, inpatients, and their relatives, along with acceptance and usability of digital screening tools.

149 participants including relatives, outpatients, and inpatients were randomised using established analogue screening versus digital screening with text‐based instructions or digital screening with video‐based instructions for the Distress Thermometer and rated their distress. Participants then provided ratings for usability and acceptance of digital screening measures.

Overall distress levels on average were high for all, inpatients, outpatients and relatives. There were no significant differences between groups in overall distress levels. Inpatients without wish for counseling reported greater physical distress and lower psychological and psychosocial distress than inpatients with wish for counseling, who were similar to relatives and outpatients. Participants expressed high overall satisfaction with digital screening measurements. Digital screening with text‐based instructions seems to be superior to analogue screening or video‐based screening, regardless of age and gender, when people have hands‐on experience. Patients and relatives using analogue screening are more skeptical of digital screening, especially elderly and female users.

Our study offered valuable insights into the varying distress levels of inpatients, outpatients, and relatives, which leads to the implication that outpatients and relatives should also be screened closely. The decisive variable was wish for counseling. There is a need for more counseling options for both cancer patients and their relatives. Our findings support the use of digital screening methods for patients and relatives. The hands‐on experience seems to be crucial for a higher acceptance.